Korean Journal of Nephrology 1997;16(1):106-113.

신이식후 당뇨병 발생과 위험인자

홍성표 , 이태원 , 임천규 , 김명재

Abstract

To investigate the clinical characteristics and predisposing factors for post-renal transplant diabetes mellitus (PTDM) in Kyung Hee University Medical Center, the records of all renal allograft recipients from 1985 through 1994 were reviewed. One hundred and seventy-nine nondiabetic recipients, whose allo- grafts functioned longer than 6 months, were an- alyzed for the development of PTDM and the following results were obtained. Twenty two (12.3%) patients developed diabetes mellitus one week to 7 months after transplantation', sixteen of whom were diagnosed within the first 2 months of transplantation. Posttransplant diabetic patients were older (41±8,5 vs. 34.8±10.8, p<0.05) than those without PTDM. The prevalence of PTDM was significantly higher in patients who received grafts from unrelated donors (p<0.05). Mean fasting blood glucose level of diabetic group was higher than that of nondiabetic group but both of which were within normal range. In HLA phenotypes in 148 renal transplant recipients, the frequencies of HLA-Aw33, -Bw58, -DR7, and -DQw2 were higher in PTDM group, compared with non diabetic group. Family history of diabetes mellitus, the prevalence of posttransplant hypertension, the male to female ratio, and type of immune suppression were similar in both groups. To identify predisposing factors, 44 non diabetic patients matched for age, sex, and time of transplant were used as case controls. There were no differences in cyclosporine or cumulative steroid dose, weight gain after transplant, and graft function at the onset of diabetes between the patients with PTDM and case controls. Our data show that the incidence of PTDM is 12.3% and most of them develop within the first 2 months after transplantation. The risk of PTDM is higher in older patients and those with unrelated donor, higher fasting blood glucose levels, and those with HLA-Aw33, -Bw58, -DR7, DQwZ antigens. It appears to be independent of the amount of prednisone and/or cyclosporine employed.